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NR601 Final

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Exam of 117 pages for the course NR601 at NR601 (NR601 Final)

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NR601 Final
Study online at https://quizlet.com/_g4omw1

1. ____ 1. An elderly client presents with a new onset of B
feeling her heart race and fatigue. An EKG reveals
atrial fibrillation with rate >110. The patient also has a
new fine tremor of both hands. Which of the
following would the nurse practitioner suspect?
A. Hypothyroidism
B. Hyperthyroidism
C. Congestive heart failure
D. Type 2 diabetes mellitus

2. ____ 2. A 62-year-old female complains of fatigue and B
lack of energy. Constipation has increased and the
patient has gained ten pounds in the past 3 months.
Depression is denied although the patient reports a
lack of interest in usual hobbies. Vital signs are within
normal limits and the patient's skin is dry and cool.
Which of the following must be included in the differ-
ential?
A. Hyperthyroidism
B. Hypothyroidism
C. Hyperparathyroidism
D. Grave's disease

3. ____ 3. Mrs. Black, an 87-year-old patient, has been B
taking 100 mcg of Synthroid for 10 years. She comes
to
your office for a routine follow-up, feeling well. Her
heart rate is 90. Your first response is to:
A. Increase the Synthroid
B. Order TSH
C. Start a beta-blocker
D. Order thyroid scan


, NR601 Final
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4. ____ 4. Which patient is most likely to have osteoporo- A
sis?
A. An 80-year-old underweight male who smokes and
has been on steroids for
psoriasis
B. A 90-year-old female with no family history of os-
teoporosis who is on hormone
replacement therapy
C. A 68-year-old overweight female who drinks 1-2
drinks alcohol/day
D. An 82-year-old female with a normal BMI takes
calcium and performs weight-
bearing exercise daily

5. ____ 5. When evaluating the expected outcome for a 5. ANS: B
hypothyroid elderly patient placed on levothyroxine, PTS: 1
the nurse practitioner will:
A. Assess a weekly TSH
B. Assess the TSH in 4-6 weeks
C. Ask the patient if the symptoms have subsided and
adjust dosage accordingly
D. Decrease the dosage should a cardiac event occur

6. ____ 6. A postmenopausal woman with osteoporosis is 6. ANS: B
taking a bisphosphonate daily by mouth. What action PTS: 1
information statement would indicate the patient un-
derstood the nurse practitioner's instructions
regarding this medication?
A. Takes medication at bedtime with a full glass of
water
B. Takes medication with a full glass of water when up



, NR601 Final
Study online at https://quizlet.com/_g4omw1

in a.m. 30 minutes prior to
other food and medications
C. Takes medication when up in a.m. with a glass of
orange juice to increase
absorption
D. Takes medication sitting up and with a meal to
avoid gastrointestinal distress

7. ____ 7. The primary reason levothyroxine sodium is 7. ANS: A
initiated at a low dose in an elderly patient with PTS: 1
hypothyroidism is to prevent which of the following
untoward effects?
A. Angina and arrhythmia
B. Nausea and diarrhea
C. Confusion and delirium
D. Osteoporosis and muscle weakness

8. ____ 8. Six months ago an elderly patient was diag- 8. ANS: B
nosed with subclinical hypothyroidism. Today the pa- PTS: 1
tient
returns and has a TSH of 11.0 and complains of fa-
tigue. He has taken Synthroid 25 mcg daily as
prescribed. What is the best course of action for the
nurse practitioner?
A. Assess further for a cause of fatigue
B. Double the dose of Synthroid
C. Discontinue the Synthroid
D. Prescribe Liotrix (T3 & T4 combination)

9. ____ 9. A fluoroquinolone (Ciprofloxin) is prescribed for 9. ANS: B
a male patient with a UTI. What should the nurse PTS: 1
practitioner teach the patient regarding taking this



, NR601 Final
Study online at https://quizlet.com/_g4omw1

medication?
A. It must be taken on an empty stomach
B. Its effectiveness is decreased by antacids, iron, or
caffeine ingestion
C. It may cause a metallic aftertaste
D. Its effectiveness is not a concern and it can be taken
with any medications

10. ____ 10. A patient has been prescribed metformin (Glu- 10. ANS: B
cophage). One week later he returns with lowered PTS: 1
blood sugars but complains of some loose stools dur-
ing the week. How should the nurse practitioner
respond?
A. Discontinue the medication immediately
B. Reassure the patient that this is an anticipated side
effect
C. Double the dosage of medication and have patient
return in 1 week
D. Order a chem. 7 to check for lactic acidosis

11. ____ 11. Which of the following signs of hyperthy- 11. ANS: D
roidism commonly manifest in younger populations, PTS: 1
but is
notably lacking in the elderly?
A. Weight gain
B. Constipation
C. Bradycardia
D. Exophthalmos

12. ____ 12. A 60-year-old obese male client has type 2 B
diabetes mellitus and a lipid panel of TC = 250, HDL
=

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